SONSIEL_Joshua Littlejohn: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
OR SONSIEL Intro:
Welcome to the SONSIEL podcast, where we host interviews with the most transformational nurse scientists, innovators, entrepreneurs, and leaders. Through sharing their personal journeys, we create inspiration, provide guidance, and give you actionable ideas you can use to be a catalyst for change.
Hiyam Nadel:
Hey everyone! Welcome back to the SONSIEL podcast. I am so excited to introduce to you, Joshua Littlejohn, wait to hear his story and his journey. Welcome, Joshua! Could you, you know, tell us a little bit about yourself?
Joshua Littlejohn:
Hi Hiyam! Yeah, so I’m Joshua. I am a second-career nurse that has gone on to actually have another career even after nursing. So in 2010, I took the leap, did an accelerated program, became a nurse as a, like I said, a second-career nurse, and then from there, my story has sort of gone a little bit along the standard routes, you know, nursing at the bedside for a while. Then I wanted to do some masters, did that, and then sort of pivoted into tech, which is where I currently find myself. So I am a product manager specifically for the nurse or the clinician experience at a company called IntelyCare. I’m happy to tell you more about that a little bit later, but essentially, in a nutshell, I am a nurse who has pivoted into technology and now helps build the tools that others use.
Hiyam Nadel:
So, yes, I want to follow up more on that, but first, you said something very interesting. So this was, nursing was a second career. So what did you do prior to nursing, and then what really drove you to want to be a nurse?
Joshua Littlejohn:
Well, I think that the more people that I talk to from SONSIEL in particular, the more this story sort of resonates with them, and it’s because I say in my second-career nurse, but really it’s like a second or third career. So follow me here for a minute. So the first undergrad degree was in molecular microbiology, and then I turned around, moved to London for two and a half years, and did media, I made television, clearly nothing to do with molecular microbiology. So after London and making television for two and a half years, I moved back to the States, went back to labs, and worked in a couple of chemical/scientific laboratories for a while. And then at that point, I had a coworker who did the same accelerated program that I had done, and she recommended it to me. And given my, I’m going to say familial history, so it has nothing to do with professional sort of context, but I was the oldest of a cohort of children that was essentially the stand-in parent, for lack of a better term. So, you know, again, this resonates, this piece of the story resonates, I feel, with a lot of other people that I’ve talked to that have become nurses. From an early age, they were caregivers themselves and have sort of carried on that in a professional context. So it was, it actually was a really natural move for me to move into nursing and consider caring for other people.
Hiyam Nadel:
Really interesting, you’re throwing out a lot at me, and I want to know more. But with your initial background, do you feel that it’s helped you as a nurse?
Joshua Littlejohn:
Oh, definitely. So the molecular microbiology bit, you know, when we start talking about disease states and the human condition as far as the anatomy and pathology goes, that sort of piece to it, that was definitely helpful in a nursing context. But also the methodologies, I suppose, you know, the scientific method, how that really looks very similar to the nursing process and how the nursing process looks similar to other processes in other pieces of disparate industries, you know.
Hiyam Nadel:
Yeah, interesting. You know, I’ve met many, many nurses who had a prior career, and I just think they always, it just enriches their or our experience when we’re exposed to them. For example, you know, when a nurse has had a business background, they come at it from a different angle, which I always find really interesting and intriguing. But so tell me a little bit, so, you know, you tell me you’re a caregiver, and that’s sort of why you think it was a natural evolution into nursing, but what else inspires you in your work in healthcare?
Joshua Littlejohn:
I would say that it’s, essentially, impact. Again, if you ask nurses or police officers or firefighters, anybody in that sort of realm, why do you do what you do? The most generic response I’ve gotten is, oh, because I want to help people, or at some point in my life, I really wanted to help people, and I’ve continued on with that throughout my life. And I would have to say the same thing only because I’ve had exposure to so many other areas and careers and pieces of life, I’ve always wanted to do more than just take care of one patient and one family at a time in a hospital context, right? So impact is the sort of thing that connects all of my dots, right? So you switch over to nursing, you’re taking care of one patient, one family at a time in an acute care setting. I went on to do an MSN and an MPH, so that’s a master’s of science in nursing, and a master’s, specifically, healthcare leadership, and then a master’s of public health. And the goal there was to take care of populations, of people. And then, through that process, I actually, again, discovered tech and thought, well, what better way to have a larger impact on a population, excuse me, than literally structuring the tools and the systems by which we care for those populations? So that sort of is the natural progression to tech and making and building things that allow us to better care for patients, for populations, or to even drive the business of healthcare, right?
Hiyam Nadel:
Yeah, I really love that, and I love the way you spun that as the impact that you have versus an individual and then populations and now systems. What I believe is that nurses, when you’re in different positions like, you know, similar to yours, there are, what you produce is much more impactful when we talk about impact. And do you agree with that statement and tell me why, because you’ve been at the bedside and can utilize all that experience now to employ. Yeah.
Joshua Littlejohn:
Yeah, certainly, certainly. I would say that yes, I do agree. I think that I would place some caveats, or not necessarily limitations, it’s not really a limitation, it’s more of a know when and where you are, you and your background are definite value add versus where it’s just like a nice to have. So where is a nurse plus something else, and the something else can vary, right? So as you mentioned, is it a business context? Is it technology? Whatever that something else is, but in what context does the equation nurse plus something else equal a value add rather than, oh yeah, you’re a nurse, that’s so nice to have sort of thing. And the reason I say that is because when I, you know, I’ve had several positions at several different institutions, organizations, and what I always look for is an understanding from a hiring manager or executive leadership that they understand the value that that nurse plus something else brings to the table. And I think the value in that is that you can hire all the MBA grads that you want, that have a business background, and you can have a successful business to a certain extent, but if you are constantly making decisions based on the bottom line and that’s the only thing you take into account, then I feel, that’s an I statement, right? I feel that you are leaving something on the table, and that is the moral, ethical side of business, right? And that’s particularly important in healthcare. And you know, who better, what better part of healthcare that a nurse, the heart of healthcare, to have at the table than us, right?
Hiyam Nadel:
Oh, I so agree, and I think that’s one of the missions for SONSIEL, is not to just empower, but allow nurses to recognize that and not just ask, but really get yourself to that table because truly, we bring different perspectives to the table. And it would only benefit, not just the patient and their families, but the system, so that’s amazing. Yeah, I love the way you really, your perspective on that. So just to switch a little bit, so currently in your job at IntelyCare, and maybe you can tell us a little bit more about IntelyCare and what your role is. I know you talk about technology, but is it under the guise of informatics? Because I think that’s also, that position or that title is also variable from system to system.
Joshua Littlejohn:
Yeah, so there’s a lot in there, I’m going to unpack it. If I miss anything, we circle back. So what is IntelyCare? We’ll start with that. So IntelyCare is a marketplace platform similar to Uber or Lyft, those are probably the most easily accessible metaphors, right? So you have supply on one side, you have demand on the other, and in our case, it is nurses on one side who want to work per-diem shifts specifically in long-term acute care in some setting, some version of long-term acute care. And then we, on the other side, we have demand, which is facilities that have holes in their schedule that need filling with per-diem nurses. And so our platform enables individual nurses to go on to the platform and select which facilities and which schedules, which shifts on which days and etc., etc., that they want to work. So you can imagine that, whereas if you were tied to a facility and you were a full-time employee, you may or may not get the privilege of making your own schedule. Your manager may balance your schedule and tell you you have to work X number of weekends per month or x number of holidays per year or etc., etc. Our platform does away with all of that and allows the nurse to say, I don’t want to work any weekends, I don’t want to work any overnights, I don’t want to work any holidays, or conversely, I want to do all of those things and get all of the shifts that are associated with them. So that is the company in a nutshell, and what I do is I specifically focus on the clinician experience. So if it has to do, excuse me, if it has to do with any of the, we call them IPs and tele-pros, if it has anything to do with an IP all the way from the application to looking for shifts, picking up shifts, working the shifts, even the tools that our clinical quality folks use, the product has a hand in building those tools or outlining those workflows and structuring how different people, different stakeholders interact with the product from different perspectives. So product has, for instance, involvement in building the facility tools, in the clinician tools, in the back office tools, etc., etc. Is that?
Hiyam Nadel:
Yes, that’s very interesting, really, technology, and would you say that what you’re doing and then how we label or the titles of Nurse Informaticist is, are the same?
Joshua Littlejohn:
Gotcha, so a Clinical Informaticist or a Nurse Informaticist may be something that nursing folks are familiar with. It’s a branch of nursing. It’s up, and I’m saying up and coming, that’s probably a few years ago, it’s probably, I know that there are well-known, well-established nursing informatics programs out there these days, but it is, and I was a clinical informaticist at one point in my life, and it does look very similar to product management in that you have the technology on one side, you have business stakeholders on the other, and you have some sort of developer or analyst in another corner, and you’re trying to align the business needs and identify what the business problems are and solve those problems or optimize the technology to solve those business problems in some sort of way, right? That sounds very similar to product management, which is what I currently do. I think the added piece is that product is a very industry-specific thing, right? So I not, I don’t not only specify the requirements that the developers build and whatnot, but I also work with the education team, the clinical quality team, the operations team, product marketing, I do a lot with marketing, right? And I think that clinical informaticist or nurse informaticist roles are often limiting because of the context in which they’re found, which is a large healthcare system usually, right?
Hiyam Nadel:
Right.
Joshua Littlejohn:
It’s just a matter of scale and different contexts, right? They’re like cousins, I feel, right? I feel like they’re cousins of the same thing, but one has a, definitely has a more, I’m going to say academic, but maybe that’s not the right term, like health systems’ focus, and the other is industry-focused startups, big, like, it has some other non-very clinically-oriented, very healthcare systems focused role.
Hiyam Nadel:
Got it, yeah, that’s, thank you. That’s a little more clear to me because I was getting confused with what you’re doing currently versus a nurse informaticist and stuff. So just to switch again, Joshua, do you feel like you’re an innovator? And if that’s the case, when did you recognize you were one?
Joshua Littlejohn:
Yeah, I would definitely say that I have an innovator’s, a mind for innovation. Have I gone out and started my own company or have I led any huge thing in that nature? No, that’s because I would usually describe myself as a great copilot, co-founder, second-high, like second-tier high, I don’t know what you would say, but I’m the wingman to the person who wants to take charge sort of thing. That’s generally the way that I describe myself.
Hiyam Nadel:
Got it.
Joshua Littlejohn:
But those people themselves also need to be innovators, right?
Hiyam Nadel:
That’s right.
Joshua Littlejohn:
You have to have a certain tolerance for risk to put yourself out there to be like, yeah, I want to do X, Y, or Z, or, and I think the reason why I positioned myself like that is because I really like to collaborate with others. So innovation for me is all about collaboration versus I want to have everything my way, this is what we’re doing, I made all of the decisions, I need somebody to execute on my plan, which is more like I need minions rather than I need collaborators, sort of thing.
Hiyam Nadel:
Right.
Joshua Littlejohn:
I think that’s always been there. Again, if you look at my LinkedIn page, it’s like sort of, I, right now, I must say, I’ve cleaned up my LinkedIn page a lot, you have to give me credit. I’ve played it up a lot so that there is a pretty standard narrative there. But as this podcast sort of has alluded to, there’s a lot that is, that doesn’t show up there that is in my background, and I have changed things a lot. And I think that’s because I’m constantly searching for some way to add value to the thing that I’m doing right now, right?
Hiyam Nadel:
Right, and an innovator really is consistently changing and pivoting. I think that’s one of the criteria or the characteristics of that. So that’s what it sounds like you’re doing. And as an innovator, we always are up against challenges. You know, lots of times my boss would say to me, you know, Hiyam, you don’t just see through the forest, you see even beyond that, and you need to let people catch up to you. So I think when you’re visionary, and you can just see where you need to go, sometimes people don’t believe you or take you seriously. Can you speak to that? Have you noticed that? Have you felt that yourself?
Joshua Littlejohn:
Yeah, I would say that I definitely have felt that, I’ve been given much the same feedback in other forums around, you see, not just the forest, but you see past that sort of thing, and what’s your vision and how do you bring people along, sort of, I’ve been given the same feedback. I think that part of it, even getting to this point, even talking to you and being where I am right now, has been a long journey of self-work and sometimes both personal and professional. So I think one of the biggest challenges that I’ve actually faced is similar to, again, similar to you is really getting people to take me seriously. I’m going to say this, and it’s sort of a moment of vulnerability, so I’m just going to put it out there, right?
Hiyam Nadel:
Please do.
Joshua Littlejohn:
I feel that you know, along this journey, there’s been a lot of people that have, we all have implicit biases, right?
Hiyam Nadel:
Right.
Joshua Littlejohn:
You may or may not have sat through many DEI training on implicit biases, but those work out and affect people’s trajectory in different ways. So I feel like I’ve been perceived as too short, too effeminate, too gay, too awkward, too shy, and too, insert, you know, there’s several other words that I could put in there, the list goes on. But it’s that I don’t fit in with what is expected to be standard business bro sort of thing, right?
Hiyam Nadel:
Right.
Joshua Littlejohn:
So in the nursing world where, and that’s one of the things that drew me to nursing, right, is that I was able to be caring and bring that part of me to my professional identity, right? So holding somebody’s hand and you know, I have so many images that are burned into my mind of me caring for a complete and utter stranger whose name I cannot remember, but the actual act of washing someone’s feet or helping someone to the bathroom or having a really heart to heart conversation with a family member about the prognosis of the family member, that sort of stuff, because they had questions that weren’t really for the doctor. They really were more like person to person, can we talk about something, right? All of that is the moral, ethical heart of healthcare, that is the strength of nursing that is not really found in a lot of business contexts. And so that has really been a big challenge in that, how do I translate all of that vulnerable thing, that vulnerable piece of life that I really find value in into a business context? I was actually just having lunch with a coworker, and we were talking, we were lamenting over this very fact that in a business context, there’s this feeling that you, there’s a steep learning curve, one, and the learning curve has to do with hiding those authentic pieces of your life and thinking strategically or politically in a business context. So in making the transition from bedside nursing into business, I feel like nurses are, like they keep it real, right?
Hiyam Nadel:
Right, exactly.
Joshua Littlejohn:
Nurses keep it real. You’re at the bedside, I mean, we are literally at some of the most vulnerable points in people’s lives, and that’s why we have the conversations that we have and why we have them in the manner that we have them. But when you go into business, it’s like, oh, you can’t say that. Oh, you really, you can’t say that to that person, you know, or people are just, people are just like, oh, you’re too real, sort of thing, right? And it’s like, well, okay, well, at what point do you want the nurse, and at what point do you want something else? I’m trying to tell you, you know, we’ll give you an idea of X, Y, or Z, but again, it’s a balancing act and learning the boundaries of that learning curve, right? There’s sometimes a challenge.
Hiyam Nadel:
It is, absolutely. And you said something very interesting, and I hear this constantly is, finding where you fit in. And I think through SONSIEL, we hear that all the time, and people that are joining SONSIEL are saying the same thing, hey, I finally found my tribe. Do you feel that SONSIEL has helped you in your journey?
Joshua Littlejohn:
SONSIEL has definitely helped me. I mean, I had a healthy network before SONSIEL, but I think that SONSIEL has particularly helped me connect with other people with like mindsets that are nurses specifically or nurse adjacent. It’s the people, it’s the resources, it’s the connections, it’s the other forums. You know, for instance, literally, as I sit here talking to you, right? Would I, the question is, would I have had this opportunity had I not joined SONSIEL or said yes to some of the other opportunities that we’ve worked on together, right?
Hiyam Nadel:
Right, right. Yeah, I felt the same way because you do feel, you know, you’re different, right? You think differently, you see things differently. For me, that, SONSIEL has meant the same things. So I’m very excited about innovation, I’m very excited about nursing and science, what are you most excited about those three?
Joshua Littlejohn:
I think as we look to the future, I’m really excited about the prospect of big data, but I’m also a little terrified of it. So big data and specifically data mining for insights, and I guess, so one of the startups that I was previously with, envoyatHome, we, for instance, this is an application of this, it’s not big data, but it is data nonetheless, and it’s lots of data. We were a remote monitoring platform. We are, envoyatHome still exists, and essentially we monitor the space instead of the person. So instead of putting a wearable on somebody and tracking them 24 hours a day, we would monitor the space and then via algorithms, drive data insights, behavioral insights, if you will, off of those patterns of activity within a home. So an elder gentleman uses the restroom once or twice a night, and then over the course of three weeks, we see that ratchet up to 4 to 5 times a night. We don’t know what’s going on, but we know that something’s going on, and there should be a communication to the caregiver to schedule an appointment with the doctor. So that’s on a very small scale, right? That’s a lot of individual data coming off of one platform, 24, continuously, 24 hours a day, 7 days a week to drive all of those insights. What happens when we take that, and we multiply it by millions or billions of data points or even far more trillions of data points across a population, across time? And what are the kinds of insights, behavioral or not, that we can drive from that? And I just, I feel like it’s a double-edged sword, and we’re just now beginning to crack that open, right? Crack that box open.
Hiyam Nadel:
But it’s interesting. So why do we, let’s take Amazon or Netflix, I love it when they suggest things to me. So, and they’re studying our behavior and stuff. Why do you feel that’s different, or is it different?
Joshua Littlejohn:
Oh, it’s very different. It’s very different.
Hiyam Nadel:
Tell us about that.
Joshua Littlejohn:
My behavior, as a consumer, I’m more willing to put out there, because the value proposition is that I get better or more tailored recommendations for whatever colored sneakers I’m looking for on a Wednesday afternoon sort of thing, right? I’m totally down with that. That’s fine. But when it comes to my healthcare data, so let me liken this back to something that is physical in nature and not, sort of more ephemeral-like data, right? So when you go into a hospital and you have some sort of elective procedure, maybe it’s not even elective procedure, but they cut your toe off or something, or other, or you know, all of that is considered medical waste, and they are free to do with it whatever they want, and all of that material could be used for scientific purposes too, because at that point, it’s considered medical waste, right?
Hiyam Nadel:
Right.
Joshua Littlejohn:
And you have no control over that. What if somebody took your whatever, your I don’t know, whatever it’s, a placenta or something or other, and they went through, and they made a new billion-dollar drug, like multibillion-dollar drug out of it. You’d feel a little miffed if you found out that it was your cells that actually did that, right?
Hiyam Nadel:
Right.
Joshua Littlejohn:
And in that scenario, I’m actually thinking I have in my mind HeLa, the Henrietta Lacks cells, that are, that form the basis of many of the cancer discoveries that we made right in the last century. So HeLa cells and the Henrietta Lacks story is a perfect example of people, the medical industry taking something from someone else, creating many, many, many times more the value than it was originally, and not giving anything back really to the people, the person or the people, from which it came. And so what I look forward to is a time when we can have an exchange of data, but there’s some sort of monetization or personal, the concept of personal IP or some sort of ownership over that data so that people who are generating the data on which discoveries are made, and behavioral insights are driven, can actually be remunerated and rewarded for their contribution to new discoveries, right? That’s the hope and the dream anyway.
Hiyam Nadel:
Joshua, I love that. We need to start working on it. There’s your innovation. Yeah, I mean, that is, like, brilliant. So this has been really intriguing. What would be one thing you want to leave the audience with today, Joshua? You have many, by the way. You have many, but let’s just do the one thing.
Joshua Littlejohn:
I think that you know, it’s like 90% of life is just showing up. I forget who said that exactly, but it really is true. You know, the biggest piece of building something is saying yes to opportunities. So go to a meetup, join the SONSIEL call, get on a mailing list, go to a hackathon, whatever, whatever it is, just get outside the nursing bubble, right? We as nurses are great at talking to other nurses and lamenting over X, Y, or Z that happens to us or with us or in healthcare, but we have to get outside of that and make those connections with other folks. So say yes, and remember that showing up is 90% of life, right?
Hiyam Nadel:
That’s so true. That’s how my career started. I said yes to every pilot that they wanted to do on my unit. I’ll do it, I’ll do it. And then eventually people start to see you as an early adopter, right? And then you get involved in more and more projects. Yes, I totally agree and endorse that. Now, if our listeners wanted to reach out to you, Joshua, I know you mentioned that you’re on LinkedIn. Is there any other contact information you would like to provide or LinkedIn is your choice?
Joshua Littlejohn:
Yeah, I know LinkedIn is probably the best. I don’t know if it’s sad, or good, or great. I’m sure LinkedIn is very happy about this, but LinkedIn is actually my biggest form of, quote-unquote, social media, so it’s actually the best platform to reach me on. I’m happy to provide an email or other connection points, but LinkedIn really is probably the best way to get ahold of me.
Hiyam Nadel:
Perfect. I really want to thank you. This has been inspiring, informative, and I hope our audience feels the same way, which I’m sure they will. And thanks again, Joshua.
OR SONSIEL Outro:
Thanks for tuning in to the SONSIEL podcast. If today’s podcast inspired you, we invite you to join our tribe or support our mission by visiting us at SONSIEL.org. That’s S O N S I E L .org.
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